Majority of health facilities unpaid for SHA claims, RUPHA survey reveals
The study, conducted between December 24 and December 31, 2024, highlights significant delays and inconsistencies in SHA reimbursements, leaving many hospitals in financial distress.
The survey found that only 42% of facilities reported receiving payments for their claims, while 58% received none. Moreover, only 6% of facilities received reimbursements covering over 80% of their claims. In contrast, 30% of the surveyed facilities were paid less than 10% of their submitted claims, while 22% received reimbursements covering just 10–20% of their claims.
“These delays are crippling healthcare facilities across the country,” stated Dr. Lishenga of RUPHA. “Hospitals are struggling to keep their doors open.”
Nearly 96% of the surveyed hospitals reported severe financial strain, with private hospitals being the hardest hit.
- 89% of facilities cannot meet operational costs.
- 87% are unable to pay their staff.
- 81% struggle to pay suppliers.
These challenges have led to shortages of essential supplies and increased reliance on loans to sustain operations.
In addition to SHA claims, hospitals also reported disparities in the payment of overdue arrears by the National Hospital Insurance Fund (NHIF).
- 49% of facilities reported receiving no NHIF payments.
- 40% received payments.
- 11% were uncertain if the payments were for arrears.
Monthly trends showed minimal improvement. In October 2024, only 19% of facilities were paid, increasing slightly to 23% in November before dropping to 20% by December 24, 2024.
“The disbursement process needs urgent reforms to ensure timely and equitable payments,” Dr. Lishenga emphasized.
RUPHA has called for the adoption of equitable payment mechanisms and streamlined reconciliation processes to address the financial challenges faced by healthcare providers. The association also urged government agencies to prioritize timely disbursements to ensure the sustainability of health services across the country.
“A functional healthcare financing system is essential to deliver quality care to all Kenyans,” Dr. Lishenga concluded.
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